โข Introduction
Welcome to the most detailed article on the internet on how to start a medical residency in Germany and get a German permanent medical license. In German, the word for the permanent medical license is called ๐ฉ๐ช Approbation. A temporary medical license is called in German ๐ฉ๐ช Berufserlaubnis (BE). To be able to start working as a medical doctor and start a medical residency in Germany, you need to have one of these licenses (Article: Differences between the two in detail).
If you have the slightest doubt about a certain point or do not understand any information, ask at any time in the main Facharzt JETZT group on Facebook and on Telegram. We remind you that this article is a guidance article to help you understand things and you should not rely solely on it. You should always return to the official websites. ๐
โข General notes
โช The exams required from International Medical Graduates (IMG) do not depend on their nationality (e.g., if EU or not EU), but depend on in which country they studied medicine (more explained in step number 9).
โช The steps should not always be followed in the same chronological order to start a medical residency in Germany.
Examples
For example, you can start learning, German (step 2), before finishing medical school (step 1), or you can apply for the visa (step 7). If you are going to study German in Germany and then later on send the application for the permanent medical license(step 6). Moreover, in some German states, to apply for a medical license (step 6), you need to apply for a job(step 10) and get a job offer first.
โช This article was written with a help from Mr. Teddy Kabel, admin of the largest English group for foreign doctors in Germany. Vielen Dank ๐
โข The ten steps to start a medical residency in Germany:
1. Finish medical school
Logically, to start medical residency in Germany, you need to have received your medical degree. In most countries of the world, medical school lasts six years. In a few countries, like Germany itself or China, medical school lasts five years. The duration of medical school does not play a role in Germany.
For those who failed a year or more in medical school…
If I failed a year or more in medical school and had to repeat them, do I still have a chance to get a German medical license and work in Germany?
Certainly yes! You just need to have a recognized bachelor’s degree from a recognized university, regardless of how long you studied medicine. So, failing a year or more is not a problem. ๐ฅณ
– Are your university and faculty recognized in Germany?
Use “Anabin” website to see if your university and your medical degree are recognized in Germany. If your university and faculty have the status “H+/+”, then they are recognized in Germany. ๐ฅณ๐ This YouTube video shows you how to find this out using Anabin.
That being said, the Anabin website sometimes does not contain the names of universities recognized in Germany. So, if you did not find the name of your university, this is probably not the end of the world.
– Stop & think: Is a medical residency in Germany the best option in “your” case?
Before deciding to come to Germany and start medical residency, please read a lot about the advantages and disadvantages of medical specialization in Germany and other countries. If you want to start on a specific pathway, then you should only concentrate on it. Therefore, we wrote many articles to help you with your decision: “Thinking about coming to Germany?”
An important point in helping you in your decision is knowing if your bachelor’s degree will be considered equivalent to a German one (๐ฉ๐ช gleich/Gleichwertigkeit). This is critical because it will save you from doing the medical knowledge exam (step 9). We explained this in the following article:
By the way, if you find the above route complicated and particularly if you do not like to work with patients, there is an academic route:
๐ฉ๐ช For physicians: Doing a Masterโs or PhD degree in Germany
If you still cannot decide. Read as much as possible about this route of specialization. Look in our main Facebook group and main Telegram group, and see what doctors are discussing and what problems they are facing. You are welcome to post as many questions as you like.
โ Back to the list of 10 steps
2. Learn the German language & improve your CV to start medical residency in Germany
– Learning German
During your internship year, or already before that, start learning the German language until at least the B2 level. We recommend learning at least until the C1 level. The language is essential later on during interviews, working with patients, and even for the board exams. Besides having German Approbation, language proficiency is the most critical criterion for the selection process.
Should the language certificate be from a particular testing authority/institute? Yes…
Yes, for sure, certificates are accepted from Goethe-Institut and Telc. Both are good, but Goethe-Institut is more famous among the Germans. When you are in Germany, some might ask you: “How did you learn German in your home country, Goethe?”.
Some say, that certificates from รSD might be accepted, too. This is an Austrian exam provider.
Should I get an official certificate for each language level I finish, from A1 to B2?
Certainly No! To apply for the Approbation, only a B2 certificate is enough. To apply for the Visa, a B1 certificate is required at least.
Should I get the C2 level certificate? No…
I work in Germany since >9 years, have met hundreds of doctors, worked in 14 hospitals and had through Facharzt JETZ contact with hundreds of doctors. Despite my experience and connections through Facharzt, I have never ever met a single doctor with a C2 German certificate ๐ While having it in your CV is advantageous, the language proficiency assessed in the exam tends to be more general and literal than what is typically used in the medical field. Therefore, there’s no need to stress about obtaining a C2 certificate. Aim for a C1 certification and ensure that you can speak fluently with the least noticeable accent possible. ๐ See too our article about improving your CV.
By the way, even psychiatrists are not expected to have a C2 certificate. At the end, it is not about certificates, it is about your understanding patients and speaking clearly and fluently.
The following are articles related to doctors learning German:
– Improving CV
Even before you arrive in Germany, enhance your chances of securing your dream medical specialty in a renowned German hospital by not only focusing on learning German but also engaging in activities that bolster your CV. Discover valuable insights and guidance in another article on our website:
๐ฉ๐ช Improve CV as a foreign doctor: Before and after coming to Germany
To quickly start a medical residency in Germany, do not forget to build connections. This is important because connections will save you a lot of time, money, and stress. With Facharzt JETZT it is now possible and for free to make connections with doctors working in Germany:
๐ฉ๐ช Doctors wanting to work in Germany: How to make connections? Why? ๐ต๏ธ
๐ฉ๐ช How to make connections through our community โFacharzt JETZTโ? Get a training or even a job! ๐ฅณ๐ฅณ๐๐
โ Back to the list of 10 steps
3. Finish the internship year to start a medical residency in Germany (das Praktische Jahr)
You MUST finish an internship year to start a medical residency in Germany; either in the country where you studied medicine or in your home country.
The internship year should contain certain rotations and should have certain characteristics. We explained all of that in the following article:
Did you finish your internship year, or can you finish it in the future?
| Yes ๐ฅณ | No ๐ฅ |
|---|---|
| Congrats ๐ You are finished with step number 3. Please go to the next step (number 4) | To do it in a third country or in Germany is a complicated thing and should be avoided, not to mention that doing it in a third country would be most probably not recognized. The full details are in the following article: โFor medical doctors: Is the internship year (๐ฉ๐ช das Praktische Jahr โ PJ) a must to be able to work in Germany? 100% yes! No exceptions!โ |
โ Back to the list of 10 steps
4. Get your permanent medical license
You can get it after finishing the internship year, either in your home country or in the country where you studied medicine. This is a very important document. Without it, you cannot start a medical residency in Germany.
โ Back to the list of 10 steps
5. Prepare your documents for applying for the German permanent medical license (die Approbation)
To ensure getting a medical residency in Germany, you can start during the internship year to slowly collect all the needed documents for applying for the German permanent medical license (๐ฉ๐ช die Approbation). Be careful, do not prepare your documents too early because some documents are allowed to be maximally one to six months old at the time of application for the Approbation (For example, the police clearance certificate โ ๐ฉ๐ช die Straffreiheitsbescheinigung). A complete list of the needed documents is in the following link:
๐ฉ๐ช Required documents to apply for Approbation in Germany
– Find which documents you need exactly
The documents differ slightly between the 16 medical license authorities in the 16 German states. You can find the exact needed documents on the websites of the 16 medical license authorities. On the website of each medical license authority, the required documents and application files are listed depending on where you studied medicine; either in the European Union/European Economic Area (EU/EEA) or outside of it. Here we collected the links for you: Direct links.
The authorities do not give a lot of explanations about the documents and there are many pitfalls. Therefore, please read first exactly our article about the required documents.
– The translation of the documents
Wrongly translated documents could destroy your chances of working in Germany, or make it a nightmare. Therefore, we wrote a whole article to explain the translation of documents for you:
๐ฉ๐ช Translation of documents: Where and what to pay attention to
– The authentication
We recommend the legalization of your documents in the countries where you got them from (country of origin or the country where you studied medicine). However, in a few countries of the world, the German embassies do not legalize documents. We explained all of this here:
๐ฉ๐ช What is authentication (die Beglaubigung) & where to do it
โBack to the list of 10 steps
6. Send via mail your application for the German permanent medical license (die Approbation)
After you finish the internship year, you can send your application by mail to one of Germany’s 16 medical license authorities. Unlike the USA, Canada, or England, there is no centralized authority for that.
– To start medical residency in Germany: Proof of intention
To be able to apply for a German Approbation, you need in 14 out of 16 medical license authorities a “proof of intention”. We explained this and how to get it in the following article:
๐ฉ๐ช Applying for the Approbation: The proof of intention
The two German states which do not require proof of intention are Bavaria (๐ฉ๐ช Bayern) and Thuringia (๐ฉ๐ช Thรผringen). In Berlin, it is enough to provide email copies of answers from hospitals that refused your application for a Hospitation (medical training) (Articles: What is a Hospitation & How to apply).
– For non-EU/EEA doctors: Decide whether you want to apply for the Gleichwertigkeit
All foreign doctors need to do the Fachsprachenprรผfung (FSP) (medical language exam) (step 8).
The Kenntnisprรผfung (medical knowledge exam) (step 9), is NOT required from graduates of universities in the European Union (EU)/European Economic Area (EEA). Graduates from universities in the rest of the world should decide at the time of the approbation application if they want to register for the Kenntnisprรผfung exam or if they want to undergo the process of the Gleichwertigkeit. We explained this in step number 8.
More questions and answers about step six of the 10 steps to start a medical residency in Germany:
The ECFMG: Applying for a medical license in the USA
In the USA, the ECFMG is responsible for testing all medical doctors who want to apply for a medical license in the USA. The USMLE exams. if you ever heard of them, are conducted by the ECFMG.
Source: Wikipedia.
What are the 16 German medical license authorities (๐ฉ๐ช die Approbationsbehรถrden)?
Here is a list ๐
In which one of the 16 medical license authorities should you apply for the Approbation?
The decision should take into consideration many factors like how hard the exams in the sate are, how easy is it to get a job with Berufserlaubnis (BE), but the most important factor is if you can get the Gleichwertigkeit in that state. So, please ask firstly medical graduates from your university where you should apply for the Approbation (you can also ask in our main group on Facebook and Telegram). The following article can help you a lot in your decision:
๐ฉ๐ช Where to apply for approbation: Advantages & disadvantages of each German state
Can the application be online?
No! Never! You need to send authenticated copies of your documents by post (Article: โWhat is authentication?โ)
Can I apply simultaneously to many authorities?
Never! Do not do that!, It is not allowed, and sooner or later they will discover it.
Can I apply for Approbation in one German state and work in another?
Once you get your Approbation, you can from day one work overall in Germany. On the other hand, with a temporary medical license (Berufserlaubnis), you can work only in one German state. More details are in the comparison article between the Approbation and the Berufserlaubnis (link).
Can you change your mind and move your application for the Approbation from one German state to another?
Yes, but this takes at least 2 to 3 months. We explained here how you can move your application for the approbation from one German state to another:
Do the months/years of residency I spend working with Berufserlaubnis (temporary medical license) count for the residency period?
In the great majority of states, no. ๐ฅ More details are in the comparison article between the Approbation and the Berufserlaubni: Link.
โ Back to the list of 10 steps
7. Apply for a visa (if you need one) & travel to start medical residency in Germany
To travel to Germany, citizens of many countries in the world need to apply for a German visa. You should give the German embassy a reason for coming to Germany. We explained the reasons and other issues related to this topic in separate articles:
๐ฉ๐ช Applying for a German visa: How? Reasons for coming to Germany?
โข There are in 2024 new changes coming to the visa laws, making it easier to come & work in Germany and get the German nationality. This is thoroughly explained in the following article:
๐ฉ๐ช The Skilled Immigration Law (Das Fachkrรคfteeinwanderungsgesetz)
To get a German visa, one of the things you need is โproof of financial resourcesโ. We explained the two methods for that in this article:
8. Do the medical language exam (die Fachsprachenprรผfung – FSP)
This exam is required from all doctors who did not finish high school in Germany; even if they have a German passport. You can do it ONLY after you send your application to apply for the German permanent medical license (๐ฉ๐ช die Approbation) (step number 6) and get a reply that you can do this exam. Again, as explained in step number 5, applying for a permanent medical license is only possible after finishing medical school.
โข Detailed articles:
๐ฉ๐ช What is the medical language exam (FSP)?
๐ฉ๐ช Ultimate Fachsprachenprรผfung (FSP) preparation tips
After passing the medical language exam, the steps required from you depend on the country in which you studied medicine. We explain this in the following algorithm and table:
Did you study medicine in a country of the European Union (EU) or of the European Economic Area (EEA)?
| Yes (EU/EEA) ๐ช๐บ ๐ฎ๐ธ ๐ฑ๐ฎ ๐ณ๐ด ๐จ๐ญ | No (Rest of the world) ๐ |
|---|---|
| Congratulations ๐ฅณ๐ฅณ๐๐ After passing the medical language exam, you are going to get the approbation. ๐ฅณ๐ฅณ You do not need to read further in steps 8 or 9. Go straight to the last step (number 10). | Most graduates from outside the EU/EEA need to take the medical knowledge exam (๐ฉ๐ช die Kenntnisprรผfung). Who should now take it is explained in the next questions in yellow. |
– All about the Gleichwertigkeit/gleich & should you apply for it
What is the ๐ฉ๐ช Gleichwertigkeit/gleich?
The German word “gleich” is an adjective that means “equal or smiliar”. Gleichwertigkeit is the noun form of it.
In the context of non-EU/EEA doctors applying for the Approbation, it means that they apply for an evaluation (๐ฉ๐ช Gleichwertigkeitsprรผfung) of the subjects they studied in medical school (syllabus), of their work experience after the internship year, and the courses they attended. This evaluation process costs around 1000-1800 euros and takes between four months and 18 months (depending on state). After this waiting period, they get an answer if what was submitted is “gleich” or not. If they are gleich, then they do not need to take the medical knowledge exam and are treated like EU/EEA graduates. ๐ฅณ If they are judged to be not “gleich”, then they need to do the medical knowledge exam (Kenntnisprรผfung). ๐ฅ
How do I know if the graduates of my โbatchโ from our university get the Gleichweritgikeit?
Only if you can find ones who applied in Germany, and they told you about the answer they got. You can ask in our main group on Facebook and Telegram. More details in this article:
Should I apply for the Gleichwertigkeit?
It depends on the likelihood of your getting it.
| Highly likely | Little or no hope | |
|---|---|---|
| What should you decide? | We recommend trying to apply for the Gleichwertigkeit. | Request from the beginning in your approbation application (step 6) that you want to do the medical knowledge exam. |
| Disadvantages of the decision | โข Costs for applying for the Gleichwertigkeit (around 1000-1800 euros) โข The reply needs months. If you got at the end “not gleich”, then you should wait for an appointment for the knowledge exam like someone who sent his application for the approbation on the same day, but asked to directly do the knowledge exam. | That you might be missing getting a “gleich” if you applied for it. |
| Advantages of the decision | No knowledge exam if “gleich” | If you apply from the beginning to do the knowledge exam and did not apply for a gleich, then: 1) You can quickly register for an appointment to do the knowledge exam (appointment needs months) 2) You can start early preparing for the knowledge exam, which is a clinical exam mainly and you are not wasting time learning for it (seep step 9). |
If I applied for the Gleichwertigkeit, can I work until I receive an answer?
Yes. You can work with a ๐ฉ๐ช Berufseralubnis (BE) (temporary medical license). Read this article for the details:
๐ฉ๐ช Approbation vs Berufserlaubnis: Can I work as a doctor with Berufserlaubnis? Yes, butโฆ
Can you apply for the Approbation in one German state, do the Fachsprachenprรผfung (FSP) there, and then do the medical knowledge exam (Kenntnisprรผfung) (KP) in another German state?
Yes! This is how to move your application: Article.
Doing the FSP in one state then the KP in another state is common in the German state of Northrhine-Westphalia (NRW). This is because the medical knowledge exam there (which takes place in Mรผnster) is the hardest in Germany. In NRW, the medical language exam (FSP) takes place in two cities; either in Dรผsseldorf or in Mรผnster. In Mรผnster, the FSP is also the hardest in Germany. In Dรผsseldorf, it is normal. Therefore, after succeeding in the FSP, the doctors move their applications to do the KP in another German state.
โ Back to the list of 10 steps
9. When requested from you, do the medical knowledge exam (die Kenntnisprรผfung – KP)
As we explained in detail in step number 8, not all foreign doctors are required to do this exam. This is an oral medical exam. There is not a single MCQ question in it. ๐ฅณ This means that the exam is a friendly discussion and the doctors need at least a general outline of diseases, medications, and therapies. We wrote a detailed article about it here: “What is the medical knowledge exam (die Kenntnisprรผfung – KP)?“
Doctors who need to do a medical knowledge exam are allowed by many medical license authorities to work for 6 to 24 months with a temporary medical license (
eine Berufserlaubnis). We explained the differences between a permanent and a temporary medical license in this article:
โ๐ฉ๐ช Approbation vs Berufserlaubnis: Can I work as a doctor with Berufserlaubnis? Yes, butโฆโ
We hope that you could avoid doing a medical knowledge exam (๐ฉ๐ช die Kenntnisprรผfung) and that you now have a permanent German medical license (๐ฉ๐ช die Approbation).
Do not forget to post your photo with the Approbation document in the main group of Facharzt JETZT on Facebook and Telegram.๐๐ฅณ This will motivate others, especially if you write small tips from your experience. That would be very nice of you. ๐๐
โ Back to the list of 10 steps
10. Apply for a job (die Bewerbung um eine Stelle)
To save time, already after passing the required exams from you, and while waiting for the Approbation/Berufserlaubnis document, start applying for a job. Simply write in your job application that you passed the exam(s) and include a copy of the confirmation of that (you get this on the day of the exam). You can begin working immediately after getting the approbation certificate by mail.
โข We explained in the following articles how you can apply for a job (including free samples for your application email and your motivational letter):
โข In the following articles, we explained the job interviews and how you can fully succeed in them:
After being accepted in the job, there are small few easy steps to take. Some of them are voluntary and some are mandatory. Please do not forget them because they could cause you to earn more or less money.
โ Back to the list of 10 steps
โข YouTube video: Same steps summarized
At the end of this article, we want to assure you that if you followed carefully these 10 steps to start medical residency in Germany, we will guarantee you that you will get your German Approbation. ๐ฅณ
Herzlichen Glรผckwusnch (Congratulations) ๐
You will get the job! ๐ฅณ๐๐
Want to learn more? Questions?
Join JETZT (๐บ๐ธ now) all of our groups & ask what you like
(On mobile phone: The links are at the end of this page/ On PC: On the right side)
Further readings:
โข “Approbation in Germany”, Helena Mamiฤ โ Soprano website (Foreign doctor in Germany from Croatia), link.
โข “Getting Started with Medical Residency in Germany”, German medical residency website, link.
โข “Application Process for Medical Residency in Germany”, German medical residency website, link.
โข “Preparation of documents for Berufserlaubnis / Approbation”, your second heart blog, link.
now) all of the following groups:
Doctors in Germany ุงูุฃุทุจุงุก ุงูุนุฑุจ ูุงูุฃุฌุงูุจ ูู ุฃูู
ุงููุง รrztinnen & รrzte in Deutschland: 
Doctors for Switzerland: 
Doctors in Austria: 
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[…] and apply for a German permanent medical license (๐ฉ๐ช die Approbation). See the steps in this article. You do not need to read this article any […]
[…] Congratulations. You are treated now like EU/EEA graduates. You only need a medical langauge exam (๐ฉ๐ช die Fachsprachenprรผfung).(You do not need to read this article any longer. The steps for you here except step number 9) […]
I’m a medical student in Africa level 4 general medecin , wheeling to specialise in Germany. Just want to know the differents steps involved.
Hi Akono ๐ Steps involved in what please?
Registration for specialisation
To register for the specialisation
All the steps are mentioned above. If you mean, how to apply, then see step number 6.